Thursday, July 30, 2009

Fat, the new tobacco -- July 30, 2009 column

By MARSHA MERCER

During World War II, an ad in Sunday newspapers urged moms to “take a modern look at candy – as a food.”

The 1944 ad by the Council on Candy of the National Confectioners’ Association shows a cheese sandwich, a glass of milk and an apple next to a glossy chocolate bar. The headline: “Modern partners in eating.” Below the picture is a six-point “Nutritional Platform of Candy.”

I spotted the page at a flea market, bought it and had it framed. Candy as a food group – yes! Thank you, Greatest Generation.

These days, dark chocolate wins nutritional points for its flavonoids, but we generally see candy and other sugary treats as culprits in our super-sized society.

Two-thirds of adults and one-fifth of children are either obese or overweight, according to the Centers for Disease Control and Prevention, which just concluded a four-day “Weight of the Nation” conference. The CDC issued 24 recommendations to help communities fight the “obesity epidemic.”

Brace yourself. If obesity is a national epidemic, “crisis” can’t be far behind. The next front in the health wars is obesity, and it’s going to look a lot like the fight against tobacco. That’s good news in that the tobacco wars taught us how to change attitudes and behavior, but we’ll need to guard against demonizing people or foods.

The medical costs of obesity in the United States are staggering -- $147 billion annually, according to a new CDC study. Another new study, from the University of Virginia and the Urban Institute, put the price tag higher -- $200 billion a year. That report also said health insurance premiums for non-obese workers are $26 billion a year higher because of the medical costs of the obese.

Clearly, we’ve got to do something. The Virginia-Urban Institute study proposes a 10-percent tax on fattening foods that it says will raise $500 billion in revenue over 10 years. If combined with a subsidy to lower the price of fruits and vegetables 10 percent, the net revenue still would be more than $350 billion over the period, according to authors Carolyn L. Engelhard, Arthur Garson Jr. and Stan Dorn. Engelhard and Garson are at Virginia, where Garson is former dean of the university’s medical school. Dorn is at the Urban Institute.

The CDC report doesn’t mention higher taxes, but it cites the success of the tobacco-control model in other areas. Among the recommendations: restricting what’s sold in vending machines in schools and other public facilities as well as limiting advertisements of less-healthy foods and beverages. The Virginia-Urban Institute study proposes more aggressive strategies, including stronger warning labels on fattening foods.

Critics of the Big Brother approach will howl that food isn’t tobacco, and they’re right. For one thing, nobody has to smoke or use tobacco products to survive, but people do have to eat. And what they eat often is determined by personal economics, culture and proximity. Many inner city residents don’t have access to good stores with a variety of fresh fruits and vegetables.

And while some would argue the food industry is just selling what people want, there’s a rising chorus that it bears responsibility for rising obesity. Dr. David Kessler, former head of the Food and Drug Administration, argues in his new book, “The End of Overeating” that the industry produces highly processed foods that contain loads of salt, sugar and fat, conditioning people to want more.

The Virginia-Urban Institute report says, “While fattening food does not contain a clearly addictive chemical like nicotine, there is significant and increasing evidence that the food industry adjusts food content, triggering hard to control cravings that increase consumption of fattening food.”

It’s worth remembering that obesity is not just a matter of people lacking self-discipline. We also need to rethink the government’s role in our food.

Changing the way people eat will be tough and more complicated than convincing people to give up smoking. There’s the inconvenient truth that some fattening foods – like chocolate -- are beneficial in moderation.

The 1944 ad touted candy as a morale builder. The ad included a “War Note,” saying that all Army and Navy field rations contained candy, and 50 percent of certain kinds of candies were being set aside for the armed forces.

“So when you can’t get exactly the candy you want, remember it’s helping to build energy and morale for G.I. Joe and G.I. Jane…”